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General NPI Number Information
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NPI Number | 1609604461
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Entity Type | Organization
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Legal Business Name | PALM VALLEY MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 15749 W VERNON AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-7534
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Country | US
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Telephone | 602-810-5178
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Fax | 623-321-6489
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Provider Business Mailing Address
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Address Line | 15749 W VERNON AVE
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City | GOODYEAR
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State | AZ
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Zip | 85395-7534
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Country | US
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Telephone | 602-810-5178
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Fax | 623-321-6489
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Authorized Official
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Title or Position | FNP-C
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Name | JENNIFER GARCIA RODRIGUEZ
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Credential | FNP-C
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Telephone | 602-810-5178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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